This fall’s Affordable Care Act (ACA) website fiasco and policy cancellations are only the beginning. The individual mandate is likely to unravel this spring when we see how sick the people are who signed up on the exchanges. In the midst of the ACA’s many dysfunctions, the way forward depends on devising—and communicating—a better system. In short, only deregulation can unleash competition. And only disruptive competition, where new businesses drive out old ones, will bring efficiency, lower costs, and innovation. Health insurance should be individual. It should be portable across jobs, states, and providers. It should be lifelong and guaranteed-renewable. Insurance should protect wealth against large, unforeseen, necessary expenses, rather than act as a wildly inefficient payment plan for routine expenses. Liberalization is always politically hard, but the American people should understand that it’s a viable alternative.